. On July 11, 2019, HRSA’s Federal Office of Rural Health Policy (FORHP) recognized ten states as top performers in their work to improve the quality of care at rural hospitals. The states – Pennsylvania, Massachusetts, Michigan, Utah, Alabama, Nebraska, Illinois, Maine, Minnesota, and Wisconsin – have engaged in the FORHP-funded Medicare Beneficiary Quality Improvement Project (MBQIP), a project across 45 states designed to help federally-designated Critical Access Hospitals (CAHs) improve patient outcomes through quality reporting. Before this project, there was no federal program focused on helping these low volume hospitals prioritize quality reporting and improvement. MBQIP sets rural-specific measures for quality and provides technical assistance and resources to help CAHs improve.